Children of mothers with pain have a greater risk for pain compared to children of healthy mothers, but little work has identified mechanisms through which this risk is conferred. While the presence of chronic pain certainly presents parenting challenges, our understanding of how exposure to specific parent behaviors impacts children is limited. Identifying mechanisms through which exposure to maternal chronic pain confers risk for pain and poor health outcomes to children would enable early screening and development of preventive interventions to modify risk. The long-term goal of this research program is to identify mechanisms through which chronic pain in parents negatively impacts children and adolescents. Identification of these mechanisms will inform the development of preventative interventions for youth at increased risk for chronic pain. The incidence of childhood chronic pain increases in early puberty, which makes the transition from childhood to early adolescence a critical period for studying risk for chronic pain and related problems. The proposed study will utilize a developmental model of the impact of maternal chronic pain. Both direct and transactional mechanisms of risk transmission will be tested over the course of a three year period during the transition from childhood to early adolescence. The central hypothesis is that maternal chronic pain influences risk for child pain and negative health outcomes through several direct and transactional pathways. Maternal responses to child pain and distress, as well as physical activity parenting and overall family stress will be examined as potential mechanisms. Longitudinal models of risk transmission will be tested in a sample of mothers with chronic pain and their 8-12 year old children (n= 400 mother-child dyads). These mother-child dyads will be assessed annually over a three year period, and will report on mother pain and disability, cognitive-affective factors, physical activity parenting, and family stress. These factrs will be examined as predictors of child pain, somatic symptoms, internalizing problems, healthcare utilization, school absences, and functional limitations. Daily associations between maternal functional limitations and child risks for chronic pain will also be examined. Determining mechanisms and moderators of risk during this developmental transition will provide critical information for the design of interventions aimed at reducing pain and other negative health outcomes in at-risk youth.